There is a Difference Between Difficult and Impossible. Using OPPOSITE ACTION to curb WILLFULNESS

I find a colossal urge to resist being truthful to myself. Even though I can’t quite fathom this period of dissociation which seems to be here on an extended and highly unwelcome visit, I have also not been doing anything to actively pull myself out of it, even though I know that there are ways to help myself.

I have spent the last two years learning that DBT and my treatment team are not going to magically ‘fix’ my emotional vulnerability. And even though I would love them to just magically take all my difficulties away for me, they can’t.

It IS true though, that I have proven to myself that with hard work and dedication to my health I can help myself with the skills which have been thought to me. When I weigh up this evidence, I still find myself being willful. As stubborn as a mule!

Recovering from dysregulation requires action, but taking action when you’re emotionally overwhelmed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can be exhausting.

It’s the Catch-22 of emotional sensitivity: The things that help the most are the things that are the most difficult to do. There’s a difference, however, between something that's difficult and something that's impossible.

Looking back on past blog entries I am reminded that the key to getting over being willful is to start with a few small goals and slowly build from there. Draw upon whatever resources you have. You may not have much energy, but you probably have enough to take a short shower, care for a pet or pick up the phone to text a loved one or someone else who could also do with a boost.

While you can’t force yourself to have fun or experience pleasure, you can choose to do things that you used to or know you do enjoy. Pick up a former hobby or a sport you like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to a museum, the mountains, or the pick up a trashy magazine.

Push yourself (with compassion) to do things, even when you don’t feel like it. This is all down to OPPOSITE ACTION. You might be surprised at how much better you feel once you’re out in the world. Even if the dysregulation doesn't lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.

So with this in mind (and an extremely willful mind it can be) I took myself off a yoga class with a friend today and went to support another friend of mine who lost her father a month ago. 

I have tons of work building up for my course which I have had to put on the back burner due to grief and sickness, so I am facing it tomorrow, going to the doctor to get a sick note and asking for an extension. 

Do I feel any better? Not hugely, but ever so slightly yes. And each day being skillful all adds up to achieving a life worth living. Just remember… Rome wasn't built in a day.

Personal Responsibility and Action Plans

For a week filled with extreme emotions and tear stained streaks down my cheeks, I am feeling lighter. Clichéd as it may sound, I feel like a weight has been lifted off my mind, well actually, it’s been yanked off my mind by harsh but powerful words and my own realization that I am the only person who can ‘fix’ me.

If I was to summarize my experience of this last week of intense treatment, it would be in two simple words ‘PERSONAL RESPONSIBILITY’. I have been jolted back into reality being on this programme. No-one is going to do the work for me, no matter how much I want it; it simply is not going to happen. No prince is going to ride in on a shining white horse and save me from the BPD monster, but I can get on my own horse, learn how to ride it and trot away into the sunset myself.  Personal responsibility in my recovery involves taking action and doing what needs to be done to get well and stay well. It involves problem solving, making goals and sticking to them. It involves making promises to myself, not my family, not my team and not my friends. It involves taking ownership of my life and my future. I must remember that am an expert on myself and gain back control of my life.

I have been given a wonderful sense of empowerment, while still validating my emotions. I am so afraid of what my life will bring now that my future is so uncertain. I feel it in the pit of my stomach; I have noticed the inability to catch my breath and the hot sweats I break out in when thinking about what I will do. Yet although these emotions wash over me, and I feel them, they are not going to change or improve my situation.

I have been really trying to use the core skill OPPOSITE ACTION in response to the anxiety. My action urge is to avoid, not thinking about options, not to get advice and not to apply for opportunities. That way I can’t be disappointed again, I can’t be rejected. Yet I am also not helping the problem, I am not giving myself a chance at a LIFE WORTH LIVING, and am pilling more misery on top of misery. More fear on top of more fear.

To go ALL THE WAY with this skill, I have to stop procrastinating and ‘just do it’ as the Nike ad tells us. One of therapists always tells me that ACTIVATION PRECEEDS MOTIVATION, so even if I don’t feel like applying for the internships, jobs, courses or voluntary work I just have to do it, then I will feel the benefits of my labour after.

It’s so hard in real life though, so the way I have tackled it is by making small little steps. The number one reason we put off improving our lives is because big changes feel so scary and unattainable. Which is why breaking goals down into small steps is the secret of success. There’s less fear when you’re just concentrating on what you need to do that day, and as you stick to your good intentions, you’ll be motivated to carry on until your new habits become a way of life. I was told to write your goal down on several pieces of paper.  Hang them up everywhere.  This is my first step to focusing on my commitment. Then make lots of smaller easier to achieve goals for each step of the bigger goal.

 So here it goes; I want to get back to university. I want to do a health science related degree. I either want to study occupational therapy or midwifery. It’s been my dream since I was a teenager, and I was two years into my OT degree when I had to drop out due to BPD.

Step 1: Find out what I need to achieve to get onto course and what university I can study in.

·         I need to have the skills to stay in university for 4 years,

·         Be able to endure 8 hour days of lectures/study.

·         I need to have communication skills to be able to interact with other students.

·         I need to be able to manage stress and have good time management.

·         I need to have the finances in place to support myself for the four years.

·         I need to be physically healthy and emotionally fit.

Step 2: Finish DBT and fully engage in therapy to learn new skills.

·         Attend DBT skills group and individual therapy every week.

·         Complete all homework and be willing to learn new behaviour patterns.

·         Adhere to DBT contract to create a life worth living

Step 3: Attend a less intense course/internship/voluntary work in order to build up skills and confidence.

·         Research opportunities online with voluntary organisations and apply for any that interest me.

·         Talk to and ask others about different opportunities.

·         Update CV and write cover letters.

·         Follow up on all leads and correspondence.

Step 4: Get finances in order

·         Talk to social welfare office

·         Find out about financial aid for going back to university.

·         Continue to babysit and pick up small manageable jobs

·         Set up credit union account.

·         Try to save when I can.

Step 5: Work on personal relationships

·         Stay in touch with friends, and be appreciative of their love and support.

·         Reach out to family; be considerate and patient as they are also learning new skills.

·         Make efforts to create new friendships.

·         End destructive relationships.

·         Be honest

Step 6: Foster and develop creative talents and interests

·         Make regular time to write/attend writing classes

·         Listen to music daily, sing.

·         Keep art supplies stocked and ready to use

·         Make cards/collages/draw/paint

·         Learn new things as often as possible.

This is all I can think of right now, but I know that more steps and action plans will emerge from these rudimentary goals. It feels good to have a plan, something to work towards. i don't feel so empty ans lost. 

WILLINGNESS to get over this bump and OPPOSITE ACTION TO ENVY

Although I would like to think I am calm, rational and a judicious person when it comes to taking an objective standpoint about transgressions in my own life, simply put, these skills is severely lacking from my toolbox. I find it very hard to push aside the judgements which paralyse me and turn my thoughts into narrow, dichotomous lines which only have two end points.

As I mentioned in the last few posts, my emotions have been amplified to way out of manageable levels this past week.  All this lead to me equating many of these emotions as facts; hence I felt had to act on the emotion. The feelings almost felt like they have a mind of their own, and that I was a vessel for them to carry out their action urges. At the time I felt I had no control, but I am not trying to evade responsibility for how I treated my therapist, as I know I could have been more skilful. I could have used OPPOSITE action to my anger, or even HALF SMILE. In reflection, I see that it could have been a perfect week to also practise DISSTRESS TOLERANCE and RADICAL ACCEPTANCE.

Yesterday morning I received a letter stating that a course I had been waiting to get onto for many months had been cancelled due to lack of funding. When I first saw the letter I was super excited, as I thought it was a start date. I had been advised to hold off going to university by my team for another year until I finished DBT and instead attend this collage as it operates under recovery ethics. It seemed a perfect transitory step for me. I decided to do something creative and less academic, so picked a photography course. I really was looking forward to it. 

Now I am so disappointed that my heart literally hurts. I am so afraid; I feel I have nothing really left to look forward to now.

I went to check in with the community nurse a few hours after getting this terrible news. And I am really so very grateful and abashed to admit that he was not the invalidating type I was expecting. In truth, he sat with me for about 45 mins and listened intently to what I had to say. We came up with a plan in order to help problem solve the solution, and jointly agreed that the best outcome would be for me to attend a crisis resolution based therapy group for 8 – 10 days. It came with a warning that I would have to be willing to work at finding solutions to my problems and not to abandon self responsibility. It seems fair, if like a lot of hard work, but I am up for the challenge. I really am so appreciative for how great that nurse was. I really needed his objectivity in that moment. 

I felt calmer and more in control after the meeting, and was much more willing to stay with my family for the night, I tried not to see it as a suicide watch, but as an opportunity to spend quality time with them. I went to see my sister and her husband who are expecting a baby and are in full blown 'nesting' mode. They are buying my family home off my mother, and have done a beautiful job of renovating it and putting their own stamp on the house. I noticed that I had been avoiding seeing the house as I felt great envy towards my elder sister, who has such a perfect life and gets to have everything I want and more, and on top of that gets to have the house I grew up in, the only place I called home. I am afraid I might never fall pregnant again, so am also reluctant to talk to her about the baby and envious of her ability to carry a child. I (quite skilfully in my opinion) figured out that I was experiencing ENVY which really did not fit the facts of the situation

I put on my DBT SKILLS hat and tried to use OPPOSITE ACTION. I knew that the prompting event to the ENVY was that I was being reminded about all the things I really want but can't have. A stable home, a family, nice things.....

My HOT thoughts where:

• 'I will never have what my sister has'
• 'I am such a failure'
• My sister is more successful than I will ever be'
• 'I am inferior to my sister'
• 'My parents think she is the better sibling'
• 'life has treated my so unfairly

The biological changes and bodily experiences I felt with the envy was a slight pain in the pit of my stomach and I was extremely anxious and noticed I was feeling resentment towards my sister and her husband   I began to ruminate about how unfair I felt the situation was and how much of a failure I felt I was. My attention was very narrow and I could barely even talk to them. I OBSERVED how much I had avoided seeing my sister and the house, which had undergone so much renovation that I nearly didn't recognize it! I hadn't even offered to help with painting or decorating because I had been festering in my envy.

Although it is ok to feel envy when others have what you want, the problem here lies with the intensity of which I felt the emotion. I had checked the facts and become conscious that I had not been there to help my sister due to an out of control emotion.

I mindfully asked myself what my assumptions, belies and thoughts were about my sister buying the house and having a baby. I then tried to challenge the hot thoughts which popped up. Here is how I tried to turn the judgments into facts;

• ‘My sister is 7 years older than me, is married and in a good position to raise a child’
•   My sister and her husband have worked very hard to get everything they have and deserve it all
•    I also have many very wonderfully things. I live in a fantastic location and have so many beautiful things. Someday, with hard work, I will also have a house to live in, but for now, recover and health are my greatest assets.
• It is a very good solution to the present economic recession as my sister would not have been able to buy a house like this without help from the family
•   My sister’s children will get to grow up in the same wonderful house and we did
• I am not a failure because I am not the same as my sister, I have other attributes which make me a successful and competent person

My goal is to have a positive and functioning relationship with my sister and brother-in-law, I love them and love the bump too! So my anger and resentment to them was making me avoid them and not nurture and develop a healthy bond with them. That is the main reason that the envy needed to be challenged.

In the moment I made sure to count all my blessings and avoided exaggerating my deprivations, Marsha states that to go ALL THE WAY I must imagine that it makes sense for my sister to have all this, as she has worked hard and deserved it all.

Finally I changed my emotions by changing by behaviors and posture. I unclenched my hands and relaxed my stomach and used HALF SMILE.

I now feel my envy is more in proportion to the situation. I’m not going to lie, it’s still there, but now I feel motivated to work as hard as my sister so I can have what she has. That means I can’t just throw my hands up in the air and moan about how unfair life is, I have to get off my ass and go get it for myself!

I’m really sorry this is so long and thank you so much for taking the time to read this. 

 

Shameful Emotions

"Please not again!"

Today , being Tuesday, it was once again time for my weekly dose of skills training. I have grown to quite like our little routine of learning, and even though some of the other service users do my head in, I am finding myself more tolerant of their perceived annoyances. I am genuinely interested in how they are getting on with their skill use, even when the unrelenting crisis's overtake our sessions (which happens nearly every week!) I am overcome with empathy and understanding for them rather than intolerance and frustration. I like to take this as a sign of progression on my part, as I am not as wrapped up in my own internal suffering as I have been in the past. 

We are still on EMOTION REGULATION and have finished the first goal of UNDERSTANDING and NAMING EMOTIONS. We got given this massive set of notes on the topic of describing emotions and to be honest I didn't read it all, I've had much too much of a crap week for reading such patronizing handouts. I just flicked through it and stumbled across a very adequate-to-me section on SHAME. Its my primary emotion. My weakness. My downfall.

Shame is recognized as a powerful, painful and potentially dangerous emotion,- especially for those who don’t understand its origins or know how to manage it. Unlike guilt, which is the feeling of doing something wrong, shame is the feeling of being something wrong. When I experiences shame, I feel there is something basically wrong with me. I constantly compare some aspect of myself or behavior to a standard and nearly always feel like I do not live up to that standard. Guilt can be positive, it’s a response of psychologically healthy individuals who realize they have done something wrong. It helps them act more positively, more responsibly, often to correct what they've done. But shame is not productive, shame tends to direct individuals into destructive behaviors. When we focus on what we did wrong, we can correct it; but when we’re convinced that we are wrong as a result of shame, our whole sense of self is eroded.

Shame is the substructure for SELF-INVALIDATION I feel. It feeds the drive to 'pile misery on-top of misery' as Marsha would say! When I feel shame, I believe myself unlovable, that I do not live up to expectation, that I am a failure, unworthy of life. With these thoughts circulating around my head, it becomes a good deal easier to contemplate and justify the destructiveness of self harm. Yes I know I have not referred to my ED as self harm before, but in reality, it is, I need to stop telling myself otherwise.

I actively avoid intimacy with others and have only superficial relationships most of the time, which always deteriorate in times of stress. Isolation and loneliness are serious consequences of my shame. Self-condemning attitudes and negative self-talk reinforce the shame and ultimately lead to self-loathing and self-sabotaging ED behavior.

So much goes into expelling the energy of SHAME. The expressions and actions of my shame control my life most days. It could be hiding the after shocks of a binge, or avoiding others, terrified they know about my Bulimia. I often find myself avoiding myself too, switching off, dissociating from my shame, ignoring my emotion.. This shutting down effects me greatly. I spend hours sitting in front of a screen, looking at moving pictures but not taking anything in, lying for hours, not washing, not eating, not peeing, just fighting to push away the shame. 

It upset me to realize this SHAME hold so much power over me. But some glimmer of hope was illuminated during the teaching part of today session when we learned about challenging negative thoughts with the basic CBT model and also the DBT skill of OPPOSITE ACTION.

The idea of exposing myself to the horrible feeling of shame scares me to my core. But the main thing I must remember is that OPPOSITE ACTION is only for when the emotion does not fit the fact. So my challenge this week is to figure out a transgression for which I feel I could practice this skill, engage in behavior which sets off shame over and over. I must also go ALL THE WAY by not apologizing or trying to make up, and change my body posture to look innocent, maintain eye contact and keep my voice steady and clear.

Some ideas I might try;

• Leave a dirty plate in the kitchen overnight.
• Return an item to a shop.
• Ask for help from a friend or family member.

'I Shall Go To The Ball' OPPOSITE ACTION To Fear

 I am sitting here waiting, wishing for the moments to pass more slowly. Dreaded time has caught me by surprise this morning, dragging me into a place I would rather run and hide from. Yes tonight is the night that I have been both looking forward to yet silently wishing would never come. I admittedly have not been listening to my emotions about this event. If I am honest, I have not observed the suffocating sensation in my neck, or how hard it has been to catch my breath between the shallow gasps.

I am in full blown distress mode this morning. I feel titteringly close to losing control once again. So I must turn to DBT skills to quell my EMOTION MIND and find the calm which accompanies WISE MIND.

Firstly I can recognize that my fear is disproportionate to the situation. Yes OK, I acknowledge that it is out of my safe place. A formal ball with hundreds of new unfamiliar people is not going to be comfortable, but it will not harm me in anyway. With this in mind, the obvious skill to use is OPPOSITE TO EMOTION ACTION. For it to work, I must go ALL THE WAY with this skill to distinguish the fear and snuff out the flame of panic

Sometimes in order to change how we feel we have to act opposite to how our emotions are telling us to act.  With anxiety, instead of running from the feared circumstance, we need to approach and engage in it.

Acting opposite to how you’re feeling only works when:

• The fear is not justified.  Fear is justified when a situation is a threat to your life, health, or well being.
• You do opposite action all the way. Not just by acting opposite to how you’re feeling, but also by thinking opposite to how you’re feeling.

PROCESS OF OPPOSITE ACTION

Figure out your emotion

Figure out what action goes with that emotion.

Ask yourself ‘do I want to reduce this emotion?’

Figure out what the opposite action is.

Do the opposite action all the way.

So I will firstly decide to go and follow through with that plan. I will fix my tan, go to the hairdressers and get my make-up done. I will dress up and make sure I feel as confident as I can before I go. Once I get there it is really important that I continue to be present, and stay in the skills mindset. I will use HALF SMILE to center my nerves and help accept that it is a difficult night for me. I must make sure that both my body and mind are at the party, so no hiding in the bathroom or keeping quite. I will make small talk and remember to breath!

Wish me luck!

.

Opposite Action

I am not in the mood for being social tonight. In fact,  I am damn grouchy. So what does DBT tell us to do? (cue validating and reassuring voice...) OPPOSITE ACTION. If I am to apply a rational mind to this skill, I can see how it can be useful, but at the same time my emotion mind is yelling at me that it is just another 'get on with it' statement disguised as a skill! But hay, I will try try anything once!

First things first. Identify which primary emotion I am actively avoiding. I don't think I am angry, or sad. Both are normally too intense for OPPOSITE ACTION just yet. Yes it must be fear. I am afraid of life today.

OK, so how do I apply OPPOSITE ACTION? Marsha tells us to approach our fear and do things which gives a sense of mastery over the situation. I was asked to the movies tonight, so in the spirit of making myself feel good and practicing DBT, even though I feel like crying, hiding under the covers and not coming out for a week, I smile and accept the invitation. OH NO! NOW I actually HAVE to go.

First things first. I must do something to give myself some control over the situation. So being the girl that I am, I spend an hour washing blow-drying, straightening and preening my hair. I put on my face and feel somewhat more able to deal with the world.

During the movie, I try to go ALL-THE-WAY with the OPPOSITE ACTION. I MINDFULLY PARTICIPATE in the story line of the movie, I OBSERVE the palpitations of fear which are causing me to breakout in waves of nauseating and sweaty tremors. I am in full blown panic at this stage and all I want is to run away, to flee the movie theater and be alone.

Instead I count slowly to ten and concentrate on my breathing, and try to once again bring my attention back to the story. Finally the movie ends, and although it wasn't easy and it was far from enjoyable, at least I went, and I didn't engage in any destructive behaviors!